Fire board considers change in equipment

July 10, 2013

The Fort Myers Beach Fire Control District is looking to keep its stellar incident emergency response time down and provide better pre-hospital emergency medical care with updated specialized transport vehicle equipment.

Last Tuesday evening, Beach Fire's Emergency Medical Services officer recommended the replacement of cardiac monitors through a change in heart monitor provider when he pitched a proposal to the FMB Board of Fire Commissioners during a workshop at Town Hall.

Besides a better cost rate on the product as well as numerous maintenance issues savings and more services offered, Physio Control's LifePak 15 was disclosed to be a 25 to 2 personnel favorite over Zoll's cardiac monitors, the current provider, according to an in-house survey. Both monitors were showcased and were used for a month-long trial basis prior to the survey.

Beach Fire Capt. Randy Kraus pointed out the normal life cycle of the current monitors were coming to an end. That, coupled with performance issues of the Zoll product in 2011 and 2012, some during patient care, was a strong indication for a needed change.

"An abnormal amount of cardiac monitors had to be sent back to the manufacturer," said Kraus. "The culmination of (the age of the current monitors and that) led us to start pursuing the replacement of all the monitors."

The Beach Fire District had allocated $170,240 in its equipment reserve fund over a four-year period specifically for cardiac monitors and added $94,500 to that total as part of a budget amendment in April.

After reviewing proposals and maintenance services for both monitor vendors, Physio Control's product was considered a better buy. The recommended provider met the deadline for a bid request (Zoll was 20 days late) and offered three replacement batteries for each monitor every two years at no cost (Beach Fire has paid more than $3,000 in batteries in more than three years time), a free battery charger as part of maintenance fee (Zoll charges $225 per battery charger) and "in-field" support services maintenance through a dispatched technician (instead of mailing product in for investigation).

Physio Control also offers a more cost efficient monitor. Records show Zoll's proposal for a single monitor at a discounted price is roughly $27,317 and the 10 monitors with all the fees is $273,175, while Physio Control comes in at $242,761.90, after knocking off almost $30,000 in an 11th hour negotiation to show good faith. That would leave Beach Fire with nearly $22,000 left in their equipment reserve for the product.

"With that and their willingness to get our business and work with us, that brings this recommendation forward," said Kraus. "There are a lot of advantages in (Physio Control's) maintenance package."

Beach Fire is also expected to pursue promised money from Zoll for failed performance issues of past products. Trade-in prices have been added in the shown costs.

The personnel survey revealed that, although Physio Control's monitor was larger and heavier, it was determined to be a better product.

"Most of the respondents responded to the Physio Control survey and agreed they didn't like the size and the weight," said Kraus. "However, they recommended the product." One size component advantage is the 8-1/2 inch screen on the Physio Control device as opposed to a 6-1/2 inch screen on Zoll's.

"Once you start throwing all those different parameters on the screen, it makes a difference," said Kraus.

Heart monitors are vital to the district's rescue ability. They are used on at least 50 percent of ambulance calls due to their flexibility of services, says Kraus.

Heart monitors are more than just defibrillators and rhythm analyzers. Beach Fire records show that the devices are used for taking blood pressure, resting electrocardiogram algorithms, allowing data transfer for electronic patient care reporting, automatic ST elevation for hospital transport and CPR metronome treatments.

"It also improves the survival rate of those patients that have a ST elevation and reduces the amount of time that the hospital has to activate the cardiac catheter lab before patient revival while we are still out in the field," added Kraus.

A review of the U.S. Army Medical Corps Guidelines for Life Expectancy of Medical Equipment shows the life expectancy for cardiac monitors is 5 to 8 years, while manufacturers state 7 years. Maintenance of the product falls in line with that review.

"The Food and Drug Administration states that after a manufacturer introduces a new cardiac monitor to the marketplace, that vendor on their previous model only has to offer maintenance or produce the parts for another eight years before their obligation is up," said Kraus.

The Beach Fire Commissioners were impressed with the presentation and appeared to lean toward the recommendation.

"That does speak volumes when the people who are going to use it refers them," said Beach Fire Board chair David Brower.

"It seems pretty obvious that Zoll is not as interested in our business as Physio Control is," added Commissioner Ted Schindler.

The workshop item is expected to become an agenda item at an upcoming meeting where it can be voted on.

Ambulance transport hike

For now, Beach Fire has decided to accept a transport rate increase that was recently adopted by the Lee County Board of County Commissioners.

As of July 1, ambulance service fees are listed as $650 for basic life support and $875 for two advanced life support services. The old rate stood at $525 for basic life support and $650 for advanced life support and $700 for advanced life support2 (for patients in critical condition).

Beach Fire has been piggy-backing the County's practices procedure for a few years.

The District's collection rate has increased 4 percent from its actual billings between June 1, 2012 and May 31, 2013. During that time, there have been 1,488 calls billed (320 BLS; 1,130 ALS; 31 ALS2) for a charge of $925,250.

Hypothetically, with the increase and a collection of only 46 percent of the billing, those numbers would reflect an estimated net revenue increase of $149,046.

Commissioner Carol Morris agrees there should be a consistency between the two local governments' collection fees and cited increased operational costs and other costs that relate to the service.

"Total costs have not gone down in this economy," she said. "I think you cause more problems with having different rates."

Commissioner Brower is opposed to the hike.

"I am absolutely opposed to charging the taxpayers more for a service that we require them to have," he said.